Neurocognitive functioning in subjects with eating disorders: the influence of neuroactive steroids

Background Neuropsychological studies in subjects with eating disorders (EDs) have reported conflicting findings, which might be accounted for by several confounding variables, including neuroendocrine changes. Methods General abilities, executive functions, attention, and noneffortful learning were assessed in 45 patients with EDs and 45 healthy comparison subjects (HCS). Plasma levels of 17β-estradiol, cortisol, allopregnanolone, dehydroepiandrosterone and its sulfate metabolite (DHEA and DHEAS) were evaluated in a subsample of patients and HCS. The influence of clinical, demographic, and neuroendocrine variables on neurocognitive performance was explored. Results Patients were slower than HCS on noneffortful learning and more accurate on a spatial executive task. DHEA and DHEAS were increased and positively correlated with accuracy on the executive task, while cortisol positively correlated with speed of noneffortful learning. Conclusions A subtle impairment of noneffortful learning is the only neuropsychological deficit in patients with EDs. Changes in neuroactive steroids influence neurocognitive performance.